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HCCBG Budget <br />NAME AND ADDRESS <br />Home and Community Care Block Grant for Older Adults <br />COMMUNITY SERVICE PROVIDER <br />DOA -732 (Rev. 1/13) <br />Cabarrus County Transportation <br />County Funding Plan <br />County Cabarrus <br />1303 S Cannon Blvd., <br />July 1, 2014 through June 30, 2015 <br />Kannapolis, NC 28083 <br />Provider Services Summary <br />A <br />B <br />C <br />D <br />E <br />F <br />G <br />H <br />I <br />Ser. Delivery <br />Projected <br />Projected <br />Projected <br />Projected <br />(Check One) <br />Block Grant <br />Funding <br />Required <br />Net" <br />USDA <br />Total <br />HCCBG <br />Reimburse. <br />HCCBG <br />Total <br />Services <br />Local Match <br />Sery Cost <br />Subsidy <br />Funding <br />Units <br />Rate <br />Clients <br />Units <br />Direct <br />Purch. <br />Access <br />In -Home <br />Other <br />Total <br />Trans 250 <br />X <br />139932 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />15548 <br />155480 <br />0 <br />0 <br />155480 <br />10489 <br />13.994 <br />4043 <br />181064 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />Total <br />\ \ \ \ \ \\ <br />\ \ \ \ \ \\ <br />139932 <br />0 <br />139,932 <br />15548 <br />1554801 <br />0 <br />1 155480 <br />\ \ \ \ \ \ \ \ \ \ \ \ \\ <br />\ \ \ \ \ \ \ \ \ \ \ \ \\ <br />40431 <br />181064 <br />"Adult Day Care & Adult Day Health Care Net Service Cost <br />ADC ADHC <br />Daily Care <br />Certification of required minimum local match <br />Transportation <br />availability. Required local match will be expended <br />Authorized Signature, Title <br />Date <br />Administrative <br />simultaneously with Block Grant Funding. <br />Community Service Provider <br />Net Ser. Cost Total <br />Signature, County Finance Officer Date <br />Signature, Chairman, Board of Commissioners <br />Date <br />F -5 Page 303 <br />